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Cognitive–behavioural approaches to self-management in rheumatic disease

Nature Reviews Rheumatology volume 8, pages 553–559 (2012)Cite this article

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Abstract

Patients with rheumatic disease must adjust psychosocially and behaviourally in order to manage the impact of symptoms and treatment on their daily lives, and the emotional consequences of the disease. However, patients can improve their well-being by taking a proactive role in self-management, for example by using coping strategies. Support for patient self-management from clinical teams usually comprises information and advice on disease management; however, this largely didactic approach often focuses on the biomedical aspects of rheumatic disease, without addressing how these aspects interact with psychosocial factors to influence health behaviours and thus outcomes. A cognitive–behavioural approach based on the biopsychosocial model of rheumatic disease can facilitate the identification of effective self-management strategies through collaboration between patients and clinicians. Most patients do not require intense cognitive–behavioural therapy from a clinical psychologist; rather, basic cognitive–behavioural techniques and tools could be used by rheumatology clinical teams to expand and enhance the support already offered to patients.

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Figure 1: A cognitive–behavioural formulation based on fatigue in rheumatoid arthritis.

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Author notes

  1. S. Hewlett sarah.hewlett@uwe.ac.uk

Authors and Affiliations

  1. University of the West of England, Academic Rheumatology, Bristol Royal Infirmary, Upper Maudlin Street, BS2 8HW, Bristol, UK

    Emma Dures & Sarah Hewlett

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  2. Sarah Hewlett
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Both authors researched the data for the article, provided a substantial contribution to discussions of the content, and contributed equally to writing the article and to review and/or editing of the manuscript before submission.

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Dures, E., Hewlett, S. Cognitive–behavioural approaches to self-management in rheumatic disease. Nat Rev Rheumatol 8, 553–559 (2012). https://doi.org/10.1038/nrrheum.2012.108

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